Excerpt from Only the Hypothesis chapter :

Goals Related to This Course:

The baccalaureate nurse leader should be proficient in current leadership and management techniques, as well as developing an awareness of his or her strengths and weaknesses as a leader. Managerial tools such as change theory, quality improvement processes, budget analyses, strategic planning and performance appraisal are crucial to the baccalaureate educational experience. It is the purpose of this assignment to evaluate how knowledge of Leadership and Management in the Changing Healthcare Environment relates to the achievement of my professional goal

Investigation into recent requirements on patient care delivery and the role of the professional nurse shows me the extent to which critical thinking tools have become a core requirement of nurse practicum (as evidence, for instance, in the extremely popular approach called 'evidence-based nursing). Contemporary nursing has changed diametrically from that that it was, a half a century ago. Nurses then were expected to follow traditional roles; I see traditional nursing as being more caring than scientifically based. Today, whilst emphasis is placed on the nurturing aspect, nurses, too, are expected to critically review their teachings and evaluate them according to authoritative and recent scientific findings. This makes nursing a far more inter-disciplinary, 'serious' field.

Watson and Glazer (1980) define critical thinking as being a composite of attitudes, knowledge, and skills. These include the following:

1. The ability to recognize existence of a problem and the skills to further investigate the problem and see if one can come to a solution

1. knowledge of the nature of valid inferences, abstractions, and generalizations according to which different kinds of evidence are logically determined; and

1. Skills in applying both the attitude of a critical assessment and profile and knowledge of logical thinking skills.

I see this as being absolutely pertinent to the nursing profession since nurses need to have the ability to recognize existence of a problem, they need to possess the knowledge in order to deal with it, and they need to have the skills in order to apply their knowledge. Being current in leadership and management techniques would, therefore, entail expertise in critical thinking.

Critical thinking, important as it is, is also insufficient. According to Scheffer and Rubenfeld (2000) other characteristics, perquisite for the nursing profession, include the following: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open-mindedness, perseverance, and reflection. That is a lot. It constitutes analysis of my character. And that may be not being done on a regular basis as I progress in my nursing.

Indeed, Center to Champion Nursing in America notes that recent changes in health care system warrant that the following factors need to be instituted:

Care needs to be coordinated.

Wellness and prevention have to become much higher priorities.

Clinicians need to communicate effectively with patients -- and each other.

Patients and caregivers need more support, and that includes support in making decisions.

Too many individuals are dissatisfied with the current strands of nursing. To become a more progressive system, we need far more.

Many organizations - healthcare institutions included - use an appraisal performance system in order to track the execution and outcome of goals. I can also use Key Performance Indicators (KPIs) to measure aspects of my nursing performance as well as employing a third party, objective external assessor who can also review my general performance

3. Contextual goals - this part of the appraisal considers the context in which performance occurs.

The external environmental analysis refers to how well I do in a contextual sense. Strategies used here include the following: I will need to keep myself informed of pertinent laws and make sure that I am current with possible nursing modifications and legal additions. My plan therefore will be for me to keep myself up-to-date on legal and nursing advances and innovations.

Internal environmental analysis, on the other hand, refers to patient service and other ways that the nurse manager is adhering to safety rules and meeting patient's satisfaction.

The dimensions of my internal performance analysis can be divided into two sectors:

1. What -- the nursing results

2. How -- how I (and nurses under my supervision) accomplish their tasks